Human beings are a social animal and a person's face communicates important information to other people. A smile is a very important part of human communication and socialization. A genuine broad smile can help a person fit in and makes others who see the smile comfortable and even happy.
Teeth are an important part of a person's smile. Unattractive teeth or defects in a person's teeth can detract from the overall appearance of the face particularly when a person smiles. Dentists have long improved defective teeth with a permanent dental overlay (often referred to as a “permanent overlay” or “porcelain overlay” because they are usually made from plastic or porcelain, and are usually a veneer, crown, bridge, implant or other restoration generally all hereinafter referred to as a “prosthesis or “restoration”) to enlarge, straighten, brighten, or fill in breaks or gaps in a person's teeth. These restorations may be made from a variety of materials for example, plastics, resins, porcelains, lithium disilicate, or porcelain fused to metal. A person who has excessively small teeth in part due to excessive gums can enlarge the teeth by re-contouring the gum line with the removal of some gum tissue sometimes in conjunction with a new restoration. People with yellow teeth or dark stains in their teeth can brighten their smile with a brighter whiter restoration.
As important as a smile is, many people with serious and unsightly defects in their smile decline to have a restoration to improve the smile for various reasons. One of these reasons is that a person may not be willing to undergo a permanent and irreversible treatment unless there is a high assurance in the person's mind that the procedure will greatly enhance his/her smile and the installed restoration will be comfortable in the mouth against his/her natural teeth. The person may not have the vision or knowledge as to how such a restoration can improve his/her smile. A person may initially resist the incorporation of dental prosthesis by being under the impression that the prosthesis may be uncomfortable in the mouth. Dentists until now had no easy method to demonstrate how such a restoration can improve the smile or to counteract the fears of discomfort. As a consequence of this lack of knowledge and information, only a limited amount of potential consumers accept and undergo a restoration procedure even though this dental treatment could greatly benefit a vastly wider consumer group.
A patient may not be willing to accept a permanent restoration until he/she is fully assured with the knowledge that the restoration is right for him/her and will produce some dramatic and known result. The patient needs to see a visual image of his/her own face and smile in a dynamic setting in a more three dimensional demonstration in order to obtain the needed assurance to accept the permanent restoration.
Recently, efforts have been made to visually demonstrate to the patient how a restoration may improve his/her smile. One such attempt is to take a photograph of a person smiling and then digitally alter the teeth to produce the desired smile improvement. While the digitization can produce a number of different looks by digitally altering the teeth in a variety of ways, this process is less than optimal. The result produces a somewhat static and two dimensional look to the patient. It also gives no knowledge to the consumer related to the comfort and feel of a prosthesis in the mouth.
Attempts have been made to place a temporary molded prosthesis or restoration of an individual tooth on a person's tooth. The prosthesis may adhere to the natural tooth for a short period of time in order to demonstrate to others the benefits and potential outcome of enhancing his/her teeth for a better smile. The temporary molded restoration is made from a moldable putty formed over a model of the desired smile changes. This putty is relined with an acrylic that is cured or glued onto a patient's teeth. A second approach is via direct sculpting composite on the surface of the patient's tooth and curing the composite in place once the desired shape has been sculpted. While these methods can provide the dynamic and three dimensional demonstration needed for the potential dental patient, they are time consuming costly procedures for fitting a plurality of teeth.
Once a patient decides to undergo cosmetic dentistry and obtain a restoration, the patient's teeth are prepared to receive the restoration. The restoration is then made often using a mold impression of the prepared teeth. Recently, digital systems have been commercially available that take digital photographs, videos or scans referred generally as digital imagery to provide a digitized three dimensional virtual visual model of the prepared teeth. The digital information can be downloaded into a CAD CAM machine on site for milling of a restoration in the dental office while the patient waits or the digital information can be electronically forwarded to a lab site for fabrication of model work and/or restoration. The three dimensional digital model contains the cast of the teeth along the tooth plane; however, the mold or three dimensional digital model often does not provide adequate information as to the vertical and horizontal inclinations and facial planes with respect to the tooth plane to provide the best location of the outer surface of the restoration. In dentistry, often the generally horizontal plane is referred to as the plane of occlusion or occlusal plane. Besides the cant of the generally horizontal plane of occlusion, the horizontal plane may be shifted along the vertical plane to generally determine the incisal length of the restorations. In the situation where there is only one, two or three tooth restorations to be fabricated, often the existing or adjacent teeth are used as a reference point to determine the desired positioning (horizontal and vertical planes) and lengths of restorations to be fabricated. However in the situation where there are more teeth involved in the restoration, additional information is needed to adequately determine the desired facial planes and cant of the restorations being fabricated.
Often, for best appearances sake, the overlay teeth need to be aligned with a facial plane that is angled with respect to the plane of occlusion of the natural teeth. In other words, the desired plane of occlusion often needs to be canted with respect to the original natural plane of occlusion. Due to the existing plane being canted with respect to the rest of the face, the top of the head, the forehead, the eyebrows, the eyes, cheekbones and the interpupillary plane for example, these generally horizontal planes that are visible are used to determine at which generally horizontal position should the restoration be located to determine a new smile line.
Dentists have in the past approximated the best angle by placing a stick, such as a cotton swab, into registration paste before it has set to indicate the best position along the vertical and horizontal planes of the overlay with respect to the tooth plane. This placement was done with no visual representation of human teeth and as such could only provide approximation to the ideal position. However with the advent of digital three dimensional virtual imaging, registration paste is being eliminated along with this method of recording the desired plane of occlusion.
Another obstacle for a patient is the time needed for the preparation of a temporary overlay to be used while the permanent overlay is being manufactured. Often the temporary is made using a poly-vinyl impression, commonly referred to as a wax impression, of the patient's original teeth. The teeth are then prepared for the restoration and the temporary is formed in place by using curing material. After the material is cured, it is then trimmed, polished and cemented or bonded in place. The problem with this procedure unless a desired wax up of the desired outcome has been completed, which adds time and expense to the case, is that the patient remains with a look substantially like original teeth. The patient desires to have the look of the new veneer, while the permanent restoration is being prepared as does the dentist to provide a more predictable outcome.
Temporary multi-tooth crown shells are known, but have only been applied to cuspid teeth and rearward for example the bicuspids and molars. Until now, there have been no full arched dental temporary that can also incorporate temporary crowns or temporary implants.
What is needed is a pre-fabricated, modifiable demonstration dental template that can quickly be adhered to patients' teeth to demonstrate the look of a permanent restoration for the patient. What is also needed is a dental prosthesis in the form of a demonstration dental template that provides the visual and tactile indicator to allow the consumer or patient to make a better educated decision prior to the onset of an aesthetic dental treatment; namely the application of a permanent restoration. What is also needed is a method of visually demonstrating how a dental prosthesis can improve his/her smile. Further, what is needed is a method to use the demonstration dental template also as a visual indicator to assist in determining the desired vertical and horizontal facial planes and tooth cants. The positioning along the vertical plane determines how long the tooth should be with respect to the lips and other facial features, i.e. the incisal length of the teeth. The overlay relative to the natural tooth plane can be set in a mold or a bite can be registered in paste of the overlay to communicate information of the desired vertical and horizontal facial planes for the restoration relative to the natural teeth with the laboratory to facilitate ideal end results with respect to facial planes and symmetry.
What is also needed is to create digital imagery of the demonstration dental template after it's installed in the patient to communicate the position information of the plane of occlusion and incisal length of the overlay in a digital format.
What is also needed is a full arched temporary pre-formed, modifiable shell including front incisors that can be easily relined as needed and applied to a patient's prepared teeth as a temporary while the permanent restoration are being manufactured. What is also needed is a temporary shell that matches in size, shape and color of the demonstration dental template that is used on the patient during the fabrication process of the final restoration so that the patient is not without a provisional. What is needed is a provisional that can be fabricated quickly, easily and economically. What is needed is a provisional that is modifiable in order to be able to add or subtract to it in order to mimic closely the desired outcome of both dentist and patient.